Brain pathways that support arm recovery after stroke
Defining the Neurological Substrates of Proximal Upper Extremity Motor Control and Recovery After Stroke
This trial will try 30 hours (over 6 weeks) of targeted Arm Basis Training versus usual care to see if it improves proximal arm motor control in people 3–6 months after a first ischemic or hemorrhagic stroke with moderate to severe arm impairment.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 50 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Massachusetts General Hospital Academic / other |
| Locations | 1 site (Boston, Massachusetts) |
| Trial ID | NCT06998485 on ClinicalTrials.gov |
What this trial studies
The trial will enroll about 50 participants 3 to 6 months after a first unilateral ischemic or hemorrhagic stroke who have moderate-to-severe upper‑extremity motor impairment (UE‑FMA ≤ 44). Participants will be randomized to receive 30 hours of a protocolized Arm Basis Training delivered over six weeks or to continue usual care. Researchers will measure kinematic motor performance, structural and functional neuroimaging, and neurophysiology (including TMS) before and after the intervention to link behavioral changes to corticospinal anatomy and physiology. The goal is to determine whether intensive, targeted training improves proximal shoulder and elbow control and whether those gains correspond to measurable changes in brain pathways.
Who should consider this trial
Good fit: Ideal candidates are adults 3–6 months after a first unilateral ischemic or hemorrhagic stroke with upper‑extremity impairment (UE‑FMA ≤ 44), able to participate in a 6‑week intensive therapy program in English and without contraindications to MRI or TMS.
Not a fit: Patients unlikely to benefit include those with bilateral strokes, pre‑existing upper extremity conditions that limited use, unstable medical status, severe aphasia or cognitive deficits that prevent participation, contraindications to MRI or TMS, or a history of uncontrolled seizures.
Why it matters
Potential benefit: If successful, the findings could enable more targeted rehabilitation approaches that improve arm movement and reduce long‑term disability after stroke.
How similar studies have performed: Previous work has shown that components of post‑stroke hemiparesis map to different brain pathways and that intensive, targeted rehabilitation can produce motor gains and brain changes, but the specific link for proximal upper‑extremity control remains incompletely established.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * first time unilateral ischemic or hemorrhagic stroke occurring within the 3-6 months * upper extremity motor impairment as measured by the Upper Extremity Fugl-Meyer Assessment (UE-FMA) Score \<= 44 * ability to participate in a 6-week intensive upper extremity intervention in English as determined by a licensed occupational therapist. Exclusion Criteria: * bilateral stroke * unstable medical status affecting functional status * pre-stroke upper extremity injury or conditions that limited use * visual or auditory impairment limiting ability to participate in study procedures * significant aphasia (NIHSS sub-item 9 \> 1) or cognitive (NIHSS 1a or 1b or 1c \> 1) deficits * known or expected inability to maintain follow-up through the study intervention and post- assessment * contraindications to MRI * contraindications to TMS * known history of uncontrolled seizure disorder.
Where this trial is running
Boston, Massachusetts
- Laboratory for Translational Neurorecovery, Center for Neurotechnology and Neurorecovery, Massachusetts General Hospital — Boston, Massachusetts, United States (Recruiting)
Study contacts
- Principal investigator: David J Lin, MD — Massachusetts General Hospital
- Study coordinator: Caroline Lambert, BA
- Email: celambert@mgh.harvard.edu
- Phone: 617-726-1311
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.